It should be very clear by this stage of human historical development that many of our contemporary problems are best addressed by markets rather than by governments. Indeed, one could argue that the only manner in which resources are allocated in a rational means is only achievable by market forces, not arbitrary government figures. When markets are allowed to function, great social progress is more often than not reached. Perhaps given these sets of facts it becomes all the more puzzling as to the outright banishment of certain markets. This blog post will center on the banned market for organ sales, specifically kidney sales.
A Very Real Problem
It is an unfortunate fact that each year over 100,000 people in the United States alone await kidney transplants. Of this lot of people, only 23,000 will receive a kidney transplant. A moribund figure of 6,000 represents the number of people that die while waiting for a kidney transplant. These numbers by themselves should be very sobering figures to anyone…but the real question should be, does it have to be this way? I do not think so.
Currently the sale of organs is illegal in the United States. I believe this is a travesty and upholding this policy directly causes unnecessary pain, suffering, and death.
Reasons for the Sale of Kidneys
As mentioned earlier, there is clearly a great need for kidneys. The current supply of kidneys available for transplant is not enough to satisfy, clear, the demand for kidneys. The reason for this situation is the result of the price ceiling of $0 set by the government. At this rate, the only incentive to suppliers of kidneys is altruism. This results in a shortage of kidneys and a surplus of human suffering. If this legal price ceiling of $0 were removed, then we can reasonably expect market forces to tend towards equilibrium of price and quantity. Additional reasons may run along the lines of ‘The individual is sovereign over his body and as such should be able to do with it as he pleases as long as this does not infringe upon the sovereign rights of other persons’ That said, reasons for the sale of kidneys justified on those grounds tend to muddle the discussion far too a field of intended discussion.
Objections towards functioning kidney markets most often fall into one of three issues. Those issues are
- Issues of coercion, that only the desperately poor will provide kidneys.
- Issues of risk, that undergoing a kidney surgery is a dangerous procedure.
- Issues of quality, that people will lie about their kidney quality.
Of these stated objections, only the first one is, I think, most plausible. The second and third are easily addressed. Concerning the second objection, kidney surgery is a very low-risk procedure. Although any surgery carries risk of injury, but kidney removal is on the lower rung of risky surgeries. With regards to the third objection, basic principles of economics and contracts easily address this worry. When markets function properly, then low-quality kidneys will be excluded from sale. Furthermore, standards of quality will arise or may be imposed by the governments that require a baseline of quality. Medical examinations may be required before surgery to determine the objective status of the kidney. In addition, those found to have sold a kidney under false pretenses of quality may be sued in a court of law and held to a high degree of liability. Thus, we are left with the first objection regarding issues of coercion. Will the desperately poor be proportionality the highest sellers of kidneys? Perhaps, this may happen. However, we should stress that the kidney market would be strictly based upon voluntary exchange and as such is, at least primae facie, a moral exchange. The decision to sell a kidney should ultimately rest with the owner of that kidney and to deny ability is to deny, or at the very least not respect, the autonomy of the owner of the kidney. Objectors may claim that the conditions of the poor ‘force’ or perhaps more aptly said incentivize the poor to make ‘bad’ decisions. Yet that is a natural result of liberty, individuals should be able to make good and bad decisions for themselves regardless of what more ‘enlightened’ individuals may think be the best action. Should the poor not be allowed to eat fast food because it causes harm? Should we also then mandate good health practices? Should the poor not be allowed to make decisions that others perceive to be bad? These examples I believe are as equally absurd as the banning of kidney sales because the poor may be greater providers of kidneys rather than the more well off.
The demand for kidneys will continue to exceed supply of kidneys as long as the price ceiling of $0 remains in place. This unnecessarily prolongs human suffering, disrespects autonomy of individuals interested in selling kidneys, and promotes an overall inefficient distribution of resources in organs. These resultant outcomes I believe are far worse than if markets in kidney sales were allowed to operate properly.
 I borrowed these figures from an article by Peter Singer on the same topic.